Basic Information
| Provider Information | |||||||||
| NPI: | 1396239927 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL JERSEY URGENT CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 731 HWY 35 UNIT G | ||||||||
| Address2: | |||||||||
| City: | OCEAN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077124765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324558444 | ||||||||
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| Practice Location | |||||||||
| Address1: | 84 VERONICA AVE | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088733529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329926700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2018 | ||||||||
| LastUpdateDate: | 05/27/2022 | ||||||||
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| AuthorizedOfficialLastName: | PAPA | ||||||||
| AuthorizedOfficialFirstName: | GIANNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6178941718 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CENTRAL JERSEY URGENT CARE | ||||||||
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| NPICertificationDate: | 05/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.